System and method for facilitating delivery of patient-care

ABSTRACT

A computer-implemented method for facilitating delivery of patient-care in adherence with a standard of care clinical protocol is described. The method includes monitoring, by a computing device, patient information indicative of a clinical condition, based on a clinical protocol that comprises patient-care instructions that must be completed within a time period. The method further includes providing, by the computing device, the patient-care instructions to a user based on a result of the monitoring. The method also includes determining, by the computing device, adherence to the clinical protocol based on a result of at least one of the providing patient care instructions and the patient information; and for a determination that the clinical protocol has not been adhered to, providing a recommended action request that calibrates the patient care instructions in compliance with the clinical protocol.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application claims benefit of priority under 35 U.S.C. §119(a) fromIndian Patent Application Ser. No. 5563/CHE/2013, filed Dec. 3, 2013,the contents of which are incorporated by reference, and Indian PatentApplication Ser. No. 5564/CHE/2013, filed Dec. 3, 2013, the contents ofwhich are incorporated by reference.

BACKGROUND

1. Field

The present application generally relates to the field of clinicalhealthcare. More specifically, the present application relates to asystem and method which facilitates delivery of patient-care withadherence to standard of care clinical protocols (sometimes referred toas “clinical pathways”; herein, the term “clinical protocols” is usedcollectively to refer to clinical pathways, clinical flows, clinicalprotocols, and equivalents thereof as would be understood by thoseskilled in the art) by physicians, nurses, care-givers or patientsthemselves.

2. Related Art

Software and its distribution in the healthcare industry involve one ormore developers that develop and provide software to entities such ashealthcare providers, physicians, nurses, etc. The entities are requiredto adhere to standard of care clinical protocols while providingpatient-care using the software provided by such developers. Suchadherence is usually prescribed for mitigating undesired circumstancesand ensuring high quality patient outcomes across various patientpopulations.

The related art methods of ensuring adherence to standard of careclinical protocols involve manual chart entry and monitoring byhealthcare professionals. Such methods and systems are typically proneto manual errors. Also, such a related art approach provides weakmanagement and control over actual patient care and implementation ofpractices, and provides a lengthy feedback loop while involving variousentities ranging from patients to various roles of healthcareprofessionals and software developers. Some available automated toolsassist healthcare professionals in reducing manual errors. However, suchtools typically focus on aspects of billing, administration andmanagement, acquiring lab results, ordering tests, etc. However, none ofthese related art tools focus exclusively on timely actions for deliveryof patient care at the point of care (e.g., hospital bedside,consultation room, at home, etc.).

Changes in technology have enabled enhanced synchronization betweendifferent entities involved in providing healthcare. Certain technologysystems that exist today provide healthcare applications over multiplehealthcare platforms. However, such related art systems are directedtowards providing applications that are limited to post-care clinicaldecision analytics and billing. Further, such systems only facilitatehindsight adherence to standard of care clinical protocols throughsystematic review of system users after treatment has been completed,and do not provide real-time adherence to standard of care clinicalprotocols during treatment. Additionally, existing systems do notrecalibrate treatment actions back to standard of care clinicalprotocols when treatment has diverged from such protocols.

Further, related art systems also do not adapt a simple and easy to usegraphical user interface based on measured adherence or divergence froma standard of care clinical protocol so as to encourage adherence and/ordrive treatment actions back toward the clinical protocol whendivergence is detected.

Accordingly, there is an unmet need for systems or methods that mayassist in providing patient-care by ensuring real-time adherence tostandard of care clinical protocols, which may typically beevidence-based, established by entities such as, for example, hospitals,physicians and health authorities, as well as the patient, duringtreatment.

SUMMARY

One implementation of the present application may provide acomputer-implemented method for facilitating delivery of patient-care,the method including monitoring, by a computing device, patientinformation indicative of a clinical condition, based on a clinicalprotocol that comprises patient-care instructions that must be completedwithin a time period, providing, by the computing device, thepatient-care instructions to a user based on a result of the monitoring,determining, by the computing device, adherence to the clinical protocolbased on a result of at least one of the providing patient careinstructions and the patient information, and, for a determination thatthe clinical protocol has not been adhered to, providing a recommendedaction request that calibrates the patient care instructions incompliance with the clinical protocol.

Another implementation of the present application may further includespecifying that at least one of the patient information be provided andthe patient-care instructions be performed within the time period.

Another implementation of the present application may further includedisplaying to the user a count-down timer that is indicative of the timeperiod.

Another implementation of the present application may further include atleast one of taking one or more measurements of patient vital signs,obtaining one or more patient specimens and performing one or morelaboratory tests on the one or more patient specimens, performing one ormore radiological imaging tests on a patient or the one or more patientspecimens, performing one or more physical diagnostic tests on thepatient; and performing one or more medical procedures on the patient.

Another implementation of the present application may further includeaccessing, by the computing device, a hospital information system toretrieve additional patient information, correlating, by the computingdevice, the retrieved additional patient information with the monitoredpatient information based on the clinical protocol, and providingpatient-care instructions by displaying a combination of the retrievedadditional patient information, the monitored patient information, anddiagnostic information based on the clinical protocol.

Another implementation of the present application may further includereceiving role information of the user, requesting patient informationbased on the received role information of the user, and the patient-careinstructions are provided based on the received role information of theuser.

Another implementation of the present application may further thepatient-care instructions being provided based on a determination ofcompliance with the standard of care protocol.

Another implementation of the present application may provide anon-transitory computer readable medium storing computer executableinstructions for causing a computing device to perform the methodincluding monitoring, by a computing device, patient informationindicative of a clinical condition, based on a clinical protocol thatcomprises patient-care instructions that must be completed within a timeperiod, providing, by the computing device, the patient-careinstructions to a user based on a result of the monitoring, determining,by the computing device, adherence to the clinical protocol based on aresult of at least one of the providing patient care instructions andthe patient information, and for a determination that the clinicalprotocol has not been adhered to, providing a recommended action requestthat calibrates the patient care instructions in compliance with theclinical protocol.

Another implementation of the present application may further includemonitoring patient information specifying that at least one of thepatient information be provided and the patient-care instructions beperformed within the time period.

Another implementation of the present application may further includedisplaying to the user a count-down timer that is indicative of the timeperiod.

Another implementation of the present application may further include atleast one of taking one or more measurements of patient vital signs,obtaining one or more patient specimens and performing one or morelaboratory tests on the one or more patient specimens, performing one ormore radiological imaging tests on a patient or the one or more patientspecimens, performing one or more physical diagnostic tests on thepatient, and performing one or more medical procedures on the patient.

Another implementation of the present application may further includeaccessing, by the computing device, a hospital information system toretrieve additional patient information, correlating, by the computingdevice, the retrieved additional patient information with the monitoredpatient information based on the clinical protocol, and wherein theproviding the patient-care instructions comprises displaying acombination of the retrieved additional patient information, themonitored patient information, and diagnostic information based on theclinical protocol.

Another implementation of the present application may further includereceiving role information of the user, monitoring patient informationby requesting patient information based on the received role informationof the user; and patient-care instructions are provided based on thereceived role information of the user.

Another implementation of the present application may further includethe patient-care instructions being provided based on a determination ofcompliance with the standard of care protocol.

Another implementation of the present application may provide acomputer-implemented method for distributing patient-care mobileapplications to a user, the method including receiving, by a computingdevice, role information about the user, identifying a plurality ofpatient-care mobile applications targeted to the user based on thereceived role information, providing, by the computing device, summaryinformation for the identified plurality of patient-care mobileapplications to the user, receiving, by the computing device, selectioninformation from the user identifying one of the plurality ofpatient-care mobile applications, and granting access to the identifiedone of the plurality of patient-care mobile application.

Another implementation of the present application may further includethe role information including job information of the user within ahealthcare organization, and the one or more of the patient-care mobileapplications are identified based on the job information.

Another implementation of the present application may further includethe job information including information indicative of the user'sposition as at least one of doctor, nurse, technician, administrator,patient, and payor.

Another implementation of the present application may further includethe role information being department information identifying adepartment associated with the user within a healthcare organization,and one or more of the patient-care mobile applications may beidentified based on the department information.

Another implementation of the present application may further includethe department information including information indicative of thedepartment associated with the user as at least one of: Cardiology,Internal Medicine, Obstetrics/Gynecology, Oncology, Radiology, Surgery,Pediatrics, Neonatology, Emergency Medicine, Nephrology, andDermatology.

Another implementation of the present application may further includeaccessing, by the computing device, a hospital information system todetermine diagnosis information associated with the user when the roleinformation identifies the user as a patient, identifying the pluralityof patient-care mobile applications based on the received roleinformation by identifying the plurality of patient-care mobileapplications based on the determined diagnosis information.

Another implementation of the present application may include a systemfor facilitating delivery of patient-care, the system may include afirst computing device having a first storage and a first processorconfigured to perform monitoring patient information indicative of aclinical condition, based on a clinical protocol that comprises firstpatient-care instructions and second patient-care instructions that mustbe completed within a time period, providing the first patient-careinstructions to a first user based on a result of the monitoring,determining adherence to the clinical protocol based on a result of atleast one of the providing the first patient care instructions and thepatient information; and for a determination that the clinical protocolhas not been adhered to by the first user, providing a first recommendedaction request that calibrates the first patient care instructions incompliance with the clinical protocol, and a second computing deviceincluding a second storage and a second processor configured to performmonitoring patient information indicative of the clinical condition,based on the clinical protocol that comprises the first patient-careinstructions and the second patient-care instructions that must becompleted within a time period, providing the second patient-careinstructions to a second user based on a result of the monitoring,determining adherence to the clinical protocol based on a result of atleast one of the providing the second patient care instructions and thepatient information, and for a determination that the clinical protocolhas not been adhered to by the second user, providing a secondrecommended action request that calibrates the second patient careinstructions in compliance with the clinical protocol, wherein the firstcomputing device and the second computing device are each configured toprovide an indication of adherence to the clinical protocol of the firstuser and the second user, respectively in a common indication format.

BRIEF DESCRIPTION OF DRAWINGS

The accompanying figures wherein like reference numerals refer toidentical or functionally similar elements throughout the separate viewsand which together with the detailed description below are incorporatedin and form part of the specification, serve to further illustratevarious example implementations and to explain various principles andadvantages all in accordance with the present application.

FIG. 1 illustrates an example standard of care clinical protocol thatmay be adhered to by an example implementation of the presentapplication.

FIG. 2 illustrates an example protocol for determining Warfarin™ dosagesaccording to a standard of care clinical protocol.

FIG. 3 illustrates an example protocol for determining response topost-surgical bleeding according to a standard of care clinicalprotocol.

FIG. 4 illustrates a diagnostic chart used in the example protocol ofFIG. 3.

FIG. 5 illustrates an example protocol for treating Tachycardiaaccording to a standard of care clinical protocol.

FIG. 6 illustrates a diagram of a system for facilitating patient carewith adherence to standard of care clinical protocols in accordance withan example implementation of the present application.

FIG. 7 shows an example environment suitable for some exampleimplementations.

FIG. 8 shows an example computing environment with an example computingdevice suitable for use in some example implementations.

FIG. 9 illustrates a flowchart of a method for facilitating patient-carewith adherence to standard of care clinical protocols in accordance withan example implementation of the present application.

FIG. 10 illustrates a flowchart of a method for facilitatingpatient-care with adherence to standard of care clinical protocols inaccordance with another example implementation of the presentapplication.

FIG. 11 illustrates a user interface for facilitating patient-care withadherence to standard of care clinical protocols in accordance with anexample implementation of the present application.

FIG. 12 illustrates a user interface for facilitating patient-care withadherence to standard of care clinical protocols in accordance withanother example implementation of the present application.

FIG. 13 illustrates a user interface for facilitating patient-care withadherence to standard of care clinical protocols in accordance with athird example implementation of the present application.

FIG. 14 illustrates a user interface for facilitating patient-care withadherence to standard of care clinical protocols in accordance with afourth example implementation of the present application.

Skilled artisans will appreciate that elements in the figures areillustrated for simplicity and clarity and have not necessarily beendrawn to scale. For example, the dimensions of some of the elements inthe figures may be exaggerated relative to other elements to help toimprove understanding of example implementations of the presentapplication.

DETAILED DESCRIPTION

Before describing in detail example implementations that are inaccordance with the present application, it should be observed that theexample implementations may include combinations of method steps andsystem components for facilitating patient care with adherence tostandard of care clinical protocols. Accordingly, the method steps andsystem components have been represented where appropriate byconventional symbols in the drawings, showing only those specificdetails that are pertinent to understanding the example implementationsof the present application so as not to obscure the disclosure withdetails that will be readily apparent to those of ordinary skill in theart having the benefit of the description herein.

In this document, the terms “comprises,” “comprising,” or any othervariation thereof, are intended to cover a non-exclusive inclusion, suchthat a process, method, article, or apparatus that comprises a list ofobjects may include not only those objects but also include otherobjects not expressly listed or inherent to such process, method,article, or apparatus. An object proceeded by “comprises . . . a” doesnot, without more constraints, preclude the existence of additionalidentical objects in the process, method, article, or apparatus thatcomprises the object.

Various example implementations of the present application may provide asystem for facilitating patient care with adherence to standard of careclinical protocols and a method for utilizing the system to providepatient care with adherence to the standard of care clinical protocols.

A “standard of care clinical protocol” may be best understood as aseries of processes or treatment actions to be performed within aspecified time or under certain circumstances, which may be derived fromevidence-based healthcare practices, based on patient history and/ormeasured or perceived indicators of a patient's current status.Additionally, “clinical protocols” may be distinguished from “generalprotocols,” based on “clinical protocols” being designed to be providedin response to a specific condition or situation for which clinicaltreatment is being provided by a trained healthcare provider. Thisdistinction between clinical protocols and non-clinical, generalprotocols is well known in the art and for the sake of clarity, is notfurther discussed.

A “standard of care” example clinical protocol is illustrated in FIG. 1.As illustrated, the standard of care clinical protocol may be appliedover a period of time, across a variety of locations, by a number ofcare providers. For example, along a timeline from 0 to t, the standardof care clinical protocol(s) is applied uniformly at multiple locations(such as the Intensive Care Unit (ICU), ward/floor, and at home afterdischarge) by different care providers (such as specialists,intensivists, nurses, hospitalists, etc.) including the patient. Someprotocols may be applied in one location (e.g. Protocol—0 in FIG. 1 atthe ICU), some protocols may be applied in two locations or more (e.g.Protocol—1 in FIG. 1 at the Ward/Floor and the ICU), and some protocolsmay be applied across all locations (e.g. Protocol—2 in FIG. 1 at theWard/Floor and the ICU as well as the location of Discharge/Home).

The standard of care clinical protocol may dictate different actions orthe same action being performed at different frequencies as time goes byand the patient's location and/or caregiver changes. For example,certain vital signs or blood chemistry measures might be required to betaken hourly when in the ICU, daily during the patient's stay in thegeneral care ward/floor, and weekly when the patient has been discharged(e.g. to home, to an assisted care facility, to a hospice, etc.). Tofacilitate uniform adherence to the standard of care clinicalprotocol(s), example implementations of the present application mayinclude one or more applications (App 1, App 2, App 3, etc.) running onone or more devices (Device 1, Device 2, Device 3, etc.) a series ofsteps to be performed at prescribed times and locations, in a givencontext. The one or more applications may include a Clinical Assessmentand Recommendation Engine (CARE) to facilitate adherence to the standardof care clinical protocol. Additional details of the CARE are describedfurther below.

Though the protocol is independent of provider, location, and physicalenvironment, the clinical protocol is specific to the patient, and thecondition of the patient. A single patient may be subject to one or morestandard of care clinical protocols that are followed and tracked inparallel, overlapping, or in sequence, or any combination thereof. Byproviding the one or more applications (e.g., applications that includea CARE, such as a cardiac application that includes a CARE) running onone or more devices, adherence to all of the relevant protocols may befacilitated, which may in turn result in an overall reduction in thelength of a patient's hospital stay, an improvement in the patient'scondition/quality of treatment, and ultimately a reduction in costs byboth the patient and the institutions providing the medical care.

Example implementations of the present application may provide amechanism for adherence to the clinical protocol, and a feedbackmechanism to recalibrate treatment by providers back to the clinicalprotocols, in cases of non-adherence. This adherence and recalibrationis accomplished by one or more algorithms embedded in computerizedapplications that receive as input parameters (e.g., patient history,patient condition, patient treatment plan, location, patient vitalsigns, time, and other well-known indicators of a patient's status)relative to a clinical protocol. In some example implementations, theapplications (e.g., applications that include a CARE) may be operated,controlled or used on one or more computerized devices such as tablets,smart phones, wearables, desktop, as well as centrally controlled,server-side or cloud implemented devices.

In some example implementations, the applications and their associatedalgorithms may be operated on a single device or maybe distributedacross multiple devices. Control of the algorithm may residing in aserver (e.g. cloud) or may be passed from device to device (e.g.,client) over the course of the patient's treatment, for example, basedon device capacity, signal strength, remoteness from anoperator/administrator, convenience, level of security or other factorsthat should be well known to those skilled in the art.

The one or more devices may have a user interface (UI) with anappearance that varies based on one or more factors (such as a user'srole within a care providing institution, patient's location within thehospital, past adherence or divergence from the protocol, or otherfactor that might be apparent to a person of ordinary skill in the art.For example, a nurse may be provided with a simplified UI (FIG. 11discussed below, for example) with triggering conditions, diagnosispossibilities, requested inputs and timing conditions. Conversely, adoctor may be provided with a more detailed interface (FIG. 12 discussedbelow, for example). In other examples, the detailed interface of FIG.12 may be provided when the protocol has been adhered to, and thesimplified interface of FIG. 11 may be provided when the divergence fromthe protocol has been detected, in order to instruct the care providerwhat step or action should be taken next without any other distractinginformation in ensure compliance.

For example, but not by way of limitation, the clinical protocols may ormay not cross physical locations, online computerized devices and users.Accordingly, the following illustrative examples are provided.

FIG. 2 illustrates an example protocol for the administration ofWarfarin™ with consistent monitoring of the patient using one or moredevices running one or more applications. Warfarin™ is a vitamin Kantagonist that prevents blood from clotting. It is used to preventthrombotic complications in patients who have mechanical prostheticheart valves, have atrial fibrillation or other conditions that requireanticoagulation. The dosage of warfarin is not constant across patientsand must be closely monitored. If the dose is too high, spontaneousbleeding or excessive bleeding from minor trauma can occur. If the doseis too low, the blood can clot on the mechanical heart valve, leading toa blocked valve, a stroke, or both. However, Warfarin™ can be extremelyeffective in managing thrombotic conditions for post cardiac surgeries.

The Warfarin™ dose depends on the target INR (international normalizedratio) value, which is measured via a blood test to acquire Prothrombinlevels in blood. Thereafter, a mathematical equation is used tocalculate INR via control value to standardize the INR. Based on thetest INR value, the Warfarin™ dosage may need to be adjusted.

As illustrated in FIG. 2, a typical scenario 200 may involve a patientbeing admitted to an ICU after valve replacement surgery 205. Thepatient who underwent a heart valve replacement with a mechanical valveprosthesis has been admitted to the ICU and has started receivingWarfarin™. In the early phase 210 after heart surgery, the Warfarin™protocol is initiated. More specifically, a baseline INR is determined,a target INR value is prescribed, and the medication is administered.After Warfarin™ treatment is started 215, INR levels are monitored dailyand doses adjusted. Then, the frequency of INR measurements decreases toalternate days, and then every third day as the patient transitions fromthe ICU to general care ward of the hospital. The day-to-day dose ofWarfarin™ is determined based on the INR value. Based on the type ofvalve used in a patient, he/she may have to take warfarin for periodsranging from a few weeks to life. Therefore, the Warfarin™ dose has tobe adjusted after the patient has been discharged. Immediately followingdischarge 220, the INR measurements may be measured weekly and theneventually once a month as the patient returns to normal activity.

During each of the stages illustrated in FIG. 2, INR values may beentered into a user interface of an app (e.g., online computerizedapplication) running on one or more devices each time the patientreceives an INR report, and with the built-in algorithm of theapplication, may provide a dosage suggestion. For example, an app on atablet, PC, or wearable device may be used for entry within the hospital(e.g., in the ICU and/or in the general care ward). Once the patient hasbeen discharged, another app on a smartphone or other device may beused, thus avoiding the human error of looking at an INR value that isnot current, and in turn prescribing Warfarin™ dosage leading toundesirable consequences. Another issue may occur if a patient arrivesat treatment with a report that shows a low INR from a week ago whereasthe current INR is currently high. In such a situation, the personprescribing Warfarin™ may overlook the date on the report and increasethe dose of Warfarin™, leading to overdose and bleeding complications.The algorithm may be configured to prevent a non-current INR value thatis not current being entered prior to making a dosage recommendation.

Each value may have a guidance value as to what the target INR shouldbe, and therefore what the corresponding Warfarin™ dosage should be.Warfarin™ dosage is dynamic, since it depends on diet (e.g., eating 100grams of spinach can skew the INR value in blood test results due tospinach having a lot of vitamin K) and other factors, such as druginteractions. Other dynamic situations that can affect dosagemeasurements include a temporary liver dysfunction causing the INRvalues to shoot up which could lead to incorrect Warfarin™ dosage. Thus,Warfarin™ dosage requires close monitoring of patients. The patientstypically receive literature on diet, medications that may negativelyinteract with Warfarin™ and how to record the date/time of food eaten,as well as recommend certain situations when INR should be retestedagain. Thus, the historical information of food habits prior to INR testis in some cases useful for physicians to have and may be collected bythe applications during INR management.

By encouraging adherence to the clinical protocols, the applicationsrunning on the devices in the above discussed scenario may achievebetter outcomes for the patient by ensuring accurate warfarin dosages byadhering to the Warfarin™ protocol.

Another common scenario illustrated using FIGS. 3 and 4, which mayresult in improved patient outcomes by using applications running ondevices according the example implementations of the present applicationinvolves the monitoring of bleeding in a patient post-surgery (e.g., apediatric patient). Bleeding can occur due to multiple factors such asthe magnitude of the operation itself, the amount of dissected areas,inadequate surgical control of bleeding or inadequate optimization ofblood coagulation following heparin reversal. During surgery, drains areplaced in the pericardial and pleural cavities to drain the blood thatis shed following closure of the chest. FIG. 3 illustrates a protocol300 for monitoring bleeding and determining a course of action.Initially, bleeding of the patient is closely monitored in 305. If theblood does not drain and accumulates around the heart, it can lead topoor cardiac function and cardiac arrest from cardiac tamponade in 310,particularly if the pleura is intact and drains are non-functional. Ifthere is evidence of cardiac tamponade, the patient must be re-operatedupon quickly, blood clots evacuated and bleeding stopped in 315.

However in the absence of cardiac tamponade, the surgeon has discretionto take the patient back to the OR for examination. Some literature hasrecommended mathematical formulae based on the amount of bleeding, bodyweight and time since surgery to recommend a timely return to the OR forbleeding. FIG. 4 illustrates a diagnostic reference table that could beused to detect bleeding levels.

Using mathematical calculations, an algorithm in an application runningon a device may suggest to the operating surgeon that the threshold forre-exploration has reached. For example, the bleeding levels can bemonitored and recorded in the application, and based on the enteredlevels, the application may notify the doctor or surgeon when thebleeding reaches or exceeds the values provided in FIG. 4 in 320. In theprotocol 300, the doctor may decide to take the patient back to surgeryin 315 to evacuate blood clots and stop bleeding. Alternatively, in 325,based on the patient's condition from the perspective of coagulopathyand other medical conditions, the surgeon may decide to deferre-exploration and treat the coagulopathy with blood products orcoagulation factors and wait longer to see if the bleeding stops 335. Ifthese measures are ineffective he or she may still want to re-explorethe patient. In the protocol 300, the doctor may elect to treat thebleeding through medical management using blood products, coagulationfactors, etc., which may cause the bleeding to stop. However, if thereis evidence of tamponade in 310, the patient needs to be re-operatedupon quickly, blood clots evacuated and bleeding stopped in 315.Further, if the patient's bleeding does not respond to the medicaltreatment in 330, the doctor may decide to take the patient back tosurgery in 315 to evacuate blood clots and stop bleeding even though nocardiac tamponade has developed.

By providing recommendations to the surgeon based on entered bleedinglevels discussed in the above scenario, applications and algorithmsaccording to example implementations of the present application canencourage adherence to the foregoing clinical protocol. By encouragingadherence to the clinical protocols, the applications running on thedevices in the above discussed scenario may achieve better outcomes forthe patient by ensuring accurate quicker reaction to increased bleedinglevels.

Another scenario that may demonstrate adherence to a clinical protocolis illustrated in a scenario where a patient in the cardiac ICU beginsshowing signs of tachycardia. FIG. 5 illustrates a standard of careprotocol 500 performed in response to a patient presenting with heartrate (HR) greater than or equal to (>=) 100 beats per minute. Accordingto an example implementation of the present application, at each stagein the protocol 500 a user enters information into an applicationrunning on a computing device using a UI, such as the UI illustrated inFIGS. 11 and 12 discussed in greater detail below. Further, in responseto each entry a user is presented with an explanation of actions thatshould be taken and a timing condition within which the actions shouldbe taken using a UI, such as the UI illustrated in FIG. 13.

For example, after the triggering condition (i.e. HR>=110), a UI such asthat in FIGS. 11 and 12, may be provided requesting an assessment ofpatient mental status and measurement of Systolic Blood Pressure (SBP)within 1 minute in 505. Depending on the values entered, one of twoinstructions may be provided using another UI such as that in FIG. 13.In 510, if the patient's mental status is altered and/or the SBP is <90mmHg, the user may be instructed to immediately call for urgent backupas the patient is in serious distress. Conversely, if the patient'smental status is normal and the SBP<90 mmHg, the user may be instructedto assess the patient's cardiac rhythm, perform an Electrocardiogram(ECG), and perform an arterial blood gas (ABG) within 5 minutes. In 520,if the ECG indicates a non-sinus rhythm, the user may be instructed toask the intensivist for instructions and replace potassium (k) pursuantto Advanced ICU (AICU) protocols within 5 minutes. Conversely, in 525,if the ECG indicates a sinus rhythm, the user may be instructed to checkCentral Venus Pressure (CVP), chest tube output and connections, and askthe intensivist for instructions within 5 minutes. In 530, if the CVP ismeasured between 5 and 9, the user may be instructed to ask theintensivist for instructions and assess the pain and anxiety levels ofthe patient within 5 minutes. Conversely, in 535, if the CVP is measuredbelow 5, the user may be instructed to ask the intensivist forinstructions and administer an IV bolus of fluid within 5 minutes.Finally, in 540, if the CVP is greater than 10, the user may beinstructed to ask the intensivist for instructions within 5 minutes.

Without the active cueing provided by an application driven by analgorithm designed to encourage adherence to the protocol, all the stepsof the protocol must be remembered (e.g. memorized by a user) ormanually reviewed on paper, and there is no centralized way to notify,display and force actions within the very time-sensitive periodsillustrated in this protocol. Further, there would also be nointegration across users by a monitoring engine that monitors the inputsby the users, an adherence engine that detects whether the protocol isbeing followed and a recommendation engine that provides the next stepto be performed by the user with the UIs illustrated in FIGS. 11, 12,and 13. Conversely, actively cueing, and providing dynamic real-timefeedback in the form of recommendations based on user input the one ormore applications running on one or more devices, may increase adherenceto all of the relevant protocols, resulting in an overall reduction inthe length of a patient's hospital stay, an improvement in the patient'scondition/quality of treatment, and a reduction in costs to both thepatient and the institutions providing the medical care.

FIG. 6 illustrates a diagram of a system 600 for facilitating deliveryof patient care with adherence to standard of care clinical protocols inaccordance with an example implementation of the present application. Asillustrated, system 600 may include a clinical application store 602, acomputing device 612, patient monitoring units 630, hospital informationsystems (HIS) 632 and third party systems 634.

Clinical application store 602 may be a network based application storesimilar to existing public application stores such as, but not limitedto, the iTunes Appstore® of Apple®, the Play Store® of Google® and theBlackberry World® of Blackberry®. Further, clinical application store602 can be hosted as one of, but not limited to, a cloud based privateapplication store, a local area network based application store and awireless area network based application store and other suchimplementations. Accordingly, clinical application store 602 may beconfigured to be accessible via a network 614 such as, but not limitedto, cloud network, Local Area Network (LAN), Wireless Local Area Network(WLAN), Wireless Wide Area Network (WWAN), Wireless Metropolitan AreaNetwork (WMAN), and Wide Area Network (WAN).

Clinical application store 602 may be configured to serve as amarketplace for a plurality of patient-care applications. Each of theplurality of patient-care applications may be one of, a mobileapplication and/or a computer application. Further, each application canbe configured to work on an operating system such as, but not limitedto, Windows®, Linux®, Android™, IOS™, and UNIX. In addition, eachapplication can be configured to work according to one or more types ofinput such as, but not limited to, a keyboard input, a mouse input, atouch-based input, voice-based input and a gesture-based input.Moreover, each of the plurality of patient-care applications may beconfigured to be publicly and/or privately accessible. For example, apatient or a care giver of the patient can access the patient-careapplications which are open to public. The patient-care applicationsthat are private or proprietary applications can be accessed usingauthentication credentials by physicians, nurses and other staff on thehospital premises only.

Private or proprietary applications may be applications developedspecifically for one or more entities including one or more of, but notlimited to, hospitals, healthcare departments, healthcare providers,clinical laboratories and clinical experts. Accordingly, each of theprivate or proprietary applications may be configured such that generalpublic does not have access to the application and only authorizedpersonnel can access the application. Further, the configuration mayallow access only after successful validation of access credentialsprovided by the authorized personnel. In addition, the configuration mayallow access to privileged (e.g., confidential) data such as, but notlimited to, patient diagnosis information and healthcare providerinformation.

As illustrated in FIG. 6, the plurality of patient-care applications mayinclude condition based applications 620, symptom based applications,treatment based applications, diagnosis based applications, locationbased applications, population based applications, role basedapplications, specialty department based applications, remote monitoringbased applications, actor based applications (payor, provider, etc.),messaging applications, third party developer applications, customapplications, support applications 622, training applications 624, imageviewer applications 626 and laboratory applications 628. As may beapparent to a person of ordinary skill in the art, clinical applicationstore 602 may include other types of clinical applications than the onesmentioned above such as, compliance/audit applications, meaningful useapplications, and combinations thereof. As discussed in greater detailbelow, each application may be designed to drive compliance or adherencewith the standard of care clinical protocols independent of what type ofapplication (i.e. condition based application, support application,etc.) is involved.

Condition-based applications 620 may facilitate providing patient-carewith adherence to standard of care clinical protocols. Accordingly,condition based applications 620 may include one or more of, cardiacapplications, nephrology applications, respiratory applications,diabetes applications, arthritis applications and asthma applications.Further, each condition-based application 620 may be specific to one ormore medical conditions. For example, a condition based application maybe specific to one or more of, cardiac arrest, asthma, seizures,amputation, burns, diabetic emergencies, eye injuries, fractures, andpoisoning or infection due to catheter injuries. In addition, eachcondition based applications 620 can be designed based on one or morestandard of care clinical protocols associated with the one or moremedical conditions.

For example, a condition-based application specific to cardiac arrestcan be designed to drive adherence to a standard of care clinicalprotocol associated with cardiac arrest. Based on the standard of careclinical protocol, such an application may provide instructions orrecommendations of treatment steps to be followed by a care-giver (i.e.nurse, doctor, etc.) or by the patient as well as timing conditionswithin which each treatment step must be performed. Further, eachapplication may also be designed to receive input either automaticallyfrom automated sensors or patient vital sign monitoring devices (such asrespiration monitors, cardiac monitors, blood pressure monitors, etc.)or manually entered by a caregiver or the patient. Based on the input,the application may provide updated instructions or recommendations ofadditional treatment steps to drive adherence to the treatment clinicalprotocol.

For example, if an input indicates that the clinical protocol is beingfollowed by the caregiver or patient, the application may provide thenext step in the clinical protocol. However, if an input indicates thatthe treatment has deviated from the clinical protocol, a different stepor instruction may be provided to drive the treatment back toward theclinical protocol. In one example implementation, a standard of careclinical protocol may require that the patient perform a respiratoryvolume flow measurement 10 times per hour every hour and that the volumeflow meets or exceeds a specific volume. In response to an inputindicating that the required measurements are being taken as scheduledand are within the ranges specified by the clinical protocol, theapplication may recommend continuing the measurements for 7 days withoutconsulting a doctor. Conversely, if the input indicates that themeasurements are only being taken twice per hour and the respiratoryvolume flow measurements are repeatedly below the required volumes, theapplication may recommend that the patient immediately consult arespiratory specialist for additional treatment.

Likewise, a condition-based application specific to cardiac arrest andasthma can be based on standard of care clinical protocols for cardiacarrest and asthma, and may provide similar instructions and treatmentstep recommendations based on various inputs apparent to a person ofordinary skill in the art. Condition-based applications 620 need not belimited to the examples provided herein and numerous variations may bereadily apparent to those ordinarily skilled in the art.

Support applications 622 may include applications which are specific tosupport personnel of healthcare providers. Support personnel can be fromvarious departments such as, but not limited to, nursing, intensivist,administration, information technology, pharmacy, laboratories, mentalhealth, physiotherapy and accounts. Each application may be tailored tothe specific role of the provider for which the application is designedor targeted to ensure personnel within that role adhere to standard ofcare clinical protocols. For example, a support application 622 targetedto a nurse may provide recommendations of treatment steps that are to beperformed by a nurse according to the established treatment clinicalprotocol, such as perform vital sign measurements, administer particulardrugs, etc. Conversely, a support application targeted to an intensivistmay provide different recommendations of treatments steps of proceduresthat are typically performed by the intensivist. Regardless of theuser's role, the applications may each be tailored to drive real-timeadherence to the standard of care clinical protocol by the user byproviding recommendations of treatment steps in response to inputsindicating compliance or deviation from the clinical protocol.

Training applications 624 are designed to facilitate training of one ormore healthcare professionals such as, nurses, pharmacists andphysicians. Each application of training applications 624 may beconfigured to enable a simulation of a real-time event such as, but notlimited to, a medical emergency. For example, a training applicationspecific to an emergent asthma patient may facilitate training of anurse by providing an interface to enter details of a medical conditionof a patient. The training application may provide patient-care relatedinstructions to the nurse based on the entered details. The instructionsmay be patient-care actions which the nurse is required to perform forthe emergent asthma patient.

Image viewer applications 626 may be applications designed to enable oneor more healthcare professionals to virtually access medical imagingdata of one or more patients. The medical imaging data can include oneor more of, digital X-ray, Magnetic Resonance Imaging (MRI) data,Computer Tomography (CT) scan, ultrasound and fluoroscopy, etc.

Laboratory applications 628 enable one or more healthcare professionalsto view laboratory data stored in one or more clinical trial databases.The laboratory data can include one or more of, blood test data, urineculture data, and tissue test data, but is not limited thereto.

The plurality of patient-care applications need not be limited to theexamples illustrated in FIG. 6 and described above, and numerousvariations in the plurality of patient-care applications would bereadily apparent to those ordinarily skilled in the art.

The plurality of patient-care applications may be categorized into aplurality of levels. For example, the plurality of patient-careapplication may be classified based on requirements of one or more of, anetwork of hospitals/clinics, ahospital/clinic/nursing-home/hospice-care, a building, a floor, adepartment, a group of beds, a group of rooms, a bed and a room. Thedegree of security, data protection and access control can be differentfor different levels. For example, patient-care applications specific toone building of a hospital may not be accessible to healthcareprofessionals from another building of the same hospital. Thepatient-care applications may be tailored to provide recommendations oftreatment steps specific to the level with which it is associated. Forexample, an application may provide recommendations and request inputsspecific to a particular department of the hospital (e.g. cardiology,radiology, pharmacy, etc.). Regardless of the level or department, theapplications may each be tailored to drive real-time adherence to thestandard of care clinical protocol within the department by providingrecommendations of treatment steps in response to inputs indicatingcompliance or deviation from the clinical protocol.

A user 610 can access one or more of the plurality of patient-careapplications from clinical application store 602 to provide patient-carein accordance with standard of care clinical protocols. A user 610accessing clinical applications store 602 can be any one of, a doctor, aphysician, a nurse, a care giver, a patient, a practitioner, a labassistant, a healthcare professional, a clinical expert, a clinicalspecialist, a software or application developer, an administrator or anyother user that may be apparent to a person of ordinary skill in theart. For example, a software developer can access clinical applicationstore 602 for developing and/or improving the design of one or more ofthe plurality of patient-care applications.

User 610 can access one or more of the plurality of patient-careapplications using a computing device 612. Computing device 612 can beone of, but not limited to, a computer, a laptop, a phone, a tablet, ahandheld device, a bed-side device, a wearable device (e.g., asmartwatch), a television, and a portal digital device. Each applicationmay be tailored to provide treatment recommendations and requestinginputs specific to the capabilities of the computing device. Forexample, an application running on a wearable device with incorporatedsensors may monitor patient vitals or movements using the sensors. Asanother example, an application running on a phone, laptop, or tabletconnected to the internet or mobile cellular networks may send anautomatic email, or call a specialist when necessary based on thereceived input and the standard of care clinical protocol. For example,if the respiratory volume measurements discussed above indicate that aspecialist is needed, the application may call or email a designatedphysician. Regardless of the type of computing device being used, theapplication may be tailored to drive real-time adherence with thestandard of care clinical protocol by providing recommendations oftreatment steps in response to inputs indicating compliance or deviationfrom the clinical protocol.

Computing device 612 includes a storage and processor configured tofacilitate patient-care with adherence to standard of care clinicalprotocols. Computing device 612 can be configured to include anapplication that contains CARE. The application that contains CARE canbe installed on a computing device 612 to facilitate the recommending,downloading, installing and using other patient-care applications basedon different clinical protocols from a clinical application store 602.For example, computing device 612 may be a computer in an X-raydepartment configured to facilitate downloading, installing and/or useof X-ray related applications from clinical application store 602.Similarly, computing device 612 may be a neurologist's tablet deviceconfigured to facilitate downloading, installing and/or use of neurologyrelated applications. Taking another example, computing device 612 maybe a patient's smartphone configured to facilitate downloading,installing and/or use of publically accessible patient-careapplications.

FIG. 7 shows an example environment suitable for some exampleimplementations.

Environment 700 includes devices 705-745, and each is communicativelyconnected to at least one other device via, for example, network 760(e.g., by wired and/or wireless connections). Some devices may becommunicatively connected to one or more storage devices 730 and 745.

An example of one or more devices 705-745 may be computing device 805described below in FIG. 8. Devices 705-745 may include, but are notlimited to, a computer 705 (e.g., a laptop computing device), a mobiledevice 710 (e.g., smartphone or tablet), a television 715, a deviceassociated with a vehicle 720, a server computer 725, computing devices735-740, storage devices 730 and 745. Computing devices 760 illustratean implementation as a tablet device. Further computing device 755 alsoincludes wearable computing devices (e.g. a smartwatch). In particular,the use of wearable computing 755 devices may provide additionalfunctionality over tablets, phones, and other computing devices bydirectly monitoring patient vitals and other information by beingattached directly to the patient. Additionally, the wearable may alsofacilitate additional usage by care providers (such as doctors, nurses,etc.) by freeing one or more limbs for use in treatment, while stillfacilitating access to the computing device wearable. For example, anurse wearing a watch-like wearable computing device may be able toreview instructions, recommendations by looking at their wrist willstill having one hand free to take patient vitals.

FIG. 8 shows an example computing environment with an example computingdevice suitable for use in some example implementations. Computingdevice 805 in computing environment 800 can include one or moreprocessing units, cores, or processors 810, memory 815 (e.g., RAM, ROM,and/or the like), internal storage 820 (e.g., magnetic, optical, solidstate storage, and/or organic), and/or I/O interface 825, any of whichcan be coupled on a communication mechanism or bus 830 for communicatinginformation or embedded in the computing device 605.

Computing device 805 can be communicatively coupled to input/userinterface 835 and output device/interface 840. Either one or both ofinput/user interface 835 and output device/interface 840 can be a wiredor wireless interface and can be detachable. Input/user interface 835may include any device, component, sensor, or interface, physical orvirtual, that can be used to provide input (e.g., voice, buttons,touch-screen interface, keyboard, a pointing/cursor control, microphone,camera, braille, motion sensor, optical reader, and/or the like). Outputdevice/interface 840 may include a display, television, monitor,printer, speaker, braille, or the like. In some example implementations,input/user interface 835 and output device/interface 840 can be embeddedwith or physically coupled to the computing device 805. In other exampleimplementations, other computing devices may function as or provide thefunctions of input/user interface 835 and output device/interface 840for a computing device 605.

Examples of computing device 805 may include, but are not limited to,highly mobile devices (e.g., smartphones, devices in vehicles and othermachines, devices carried by humans and animals, and the like), mobiledevices (e.g., tablets, notebooks, laptops, personal computers, portabletelevisions, radios, and the like), and devices not designed formobility (e.g., desktop computers, other computers, information kiosks,televisions with one or more processors embedded therein and/or coupledthereto, radios, and the like).

Computing device 805 can be communicatively coupled (e.g., via I/Ointerface 825) to external storage 845 and network 850 for communicatingwith any number of networked components, devices, and systems, includingone or more computing devices of the same or different configuration.I/O interface 825 can include, but is not limited to, wired and/orwireless interfaces using any communication or I/O protocols orstandards (e.g., Ethernet, 802.11x, Universal System Bus, WiMax, modem,a cellular network protocol, and the like) for communicating informationto and/or from at least all the connected components, devices, andnetwork in computing environment 800. Network 850 can be any network orcombination of networks.

Computing device 805 can use and/or communicate using computer-usable orcomputer-readable media, including transitory media and non-transitorymedia. Transitory media include transmission media (e.g., metal cables,fiber optics), signals, carrier waves, and the like. Non-transitorymedia include magnetic media (e.g., disks and tapes), optical media(e.g., CD ROM, digital video disks, Blu-ray disks), solid state media(e.g., RAM, ROM, flash memory, solid-state storage), and othernon-volatile storage or memory.

Computing device 805 can be used to implement techniques, methods,applications, processes, or computer-executable instructions in someexample computing environments. Computer-executable instructions can beretrieved from transitory media, and stored on and retrieved fromnon-transitory media. The executable instructions can originate from oneor more of any programming, scripting, and machine languages (e.g., C,C++, C#, Java, Visual Basic, Python, Perl, JavaScript, and others).

Processor(s) 810 can execute under any operating system (OS) (notshown), in a native or virtual environment. One or more applications canbe deployed that include logic unit 860, application programminginterface (API) unit 865, input unit 870, output unit 875, monitoringunit 880, adherence unit 885, recommendation unit 890, and inter-unitcommunication mechanism 895 for the different units to communicate witheach other, with the OS, and with other applications (not shown). Forexample, monitoring unit 880, adherence unit 885, and recommendationunit 890 may implement one or more of the processes disclosed herein.The described units and elements can be varied in design, function,configuration, or implementation and are not limited to the descriptionsprovided.

In some example implementations, when information or an executioninstruction is received by API unit 865, it may be communicated to oneor more other units (e.g., logic unit 860, input unit 870, output unit875, monitoring unit 880, adherence unit 885, and recommendation unit890). As explained above, the monitoring unit 880 may be implemented toreceive information about the patient, or conditions of the patient;when the protocol is not being followed, the adherence unit 885 may takefurther steps as explained above, including on one or more devices andvia one or more user interfaces; the recommendation unit 890 mayrecommend actions to be taken, to correct the situation and recover tothe protocol.

In some instances, logic unit 860 may be configured to control theinformation flow among the units and direct the services provided by APIunit 865, input unit 870, output unit 875, monitoring unit 880,adherence unit 885, and recommendation unit 890 in some exampleimplementations described above. For example, the flow of one or moreprocesses or implementations may be controlled by logic unit 860 aloneor in conjunction with API unit 865.

In order to facilitate patient-care with adherence to standard of careclinical protocols, the computing device 612 may be configured toreceive role information of a user 610. The role information of user 610can include one or more of, but not limited to, job information, anddepartment information. The job information provides details regardinguser 610's position within a healthcare organization. The jobinformation may identify the user 610's position as one or more of, butnot limited to, a doctor, a nurse, a technician, an administrator, apatient and a payor. The department information provides detailsregarding a department associated with the user 610 within a healthcareorganization. The department information can identify the departmentassociated with user 610 as one or more of, but not limited to,Cardiology, Internal Medicine, OB/GYN, Oncology, Radiology, dermatology,neonatology, Surgery, and Pediatrics.

The computing device 612 may be further configured to identify aplurality of patient-care applications targeted to user 610 based on thereceived role information. Further, one or more of the patient-careapplications may be identified based on the job information. Forinstance, if user 610 is identified as a cardiologist, then computingdevice 612 may identify a plurality of cardiac applications for user610. In addition, one or more of the patient-care applications can beidentified based on the department information. For instance, if user610 is identified as a cardiologist who is associated with a surgerydepartment of a hospital, then computing device 612 can identify aplurality of cardiac surgery related applications for user 610.

Computing device 612 may also be configured to access a HospitalInformation System (HIS) 634 to determine diagnosis informationassociated with user 610, when the role information identifies the useras a patient. The determined diagnosis information can also be used foridentifying the plurality of patient-care applications. For example, ifuser 610 is diagnosed with a bronchial infection, then a plurality ofbronchial infection related applications can be identified for user 610.

Subsequently the computing device 612 may provide summary informationfor the identified plurality of patient-care applications to user 610.The summary information can be displayed as a list on the computingdevice 612. Further, a graphical icon corresponding to each of theidentified plurality of patient-care applications can be displayed.Computing device 612 also provides an option to select one or more ofthe identified plurality of patient-care applications to user 610 viacomputing device 612. For example, a selection label may be associatedwith each of the identified patient-care application presented in thesummary information. Accordingly, upon receiving the summaryinformation, user 610 can select one or more of the identified pluralityof patient-care applications by using the selection labels. Computingdevice 612 accordingly may enable access to the selected patient-careapplications. This may encompass downloading, installing and utilizingthe selected applications on a computing device 612. Further, anapplication including CARE that runs on a computing device 612 may beused to achieve the desired configuration.

Optionally, computing device 612 can be configured to transmit deliveryinformation to HIS 634. The delivery information may identify that theselected patient-care applications have been delivered to the user.

Once the computing device 612 is configured with the desiredpatient-care applications, the CARE can be used to provide one or moreuser interfaces (UIs) which may enable the user 610 to control themanner of interaction and utilization of the desired patient-careapplications accessed from clinical application store 602 via computingdevice 612. Thus, computing device 612 utilize one or more applicationshaving a CARE to facilitate exchange of information with user 610 byenabling user 610 to provide one or more inputs. The CARE accordinglyprovides an output based on analysis of the input data, wherein theoutput can include recommendations for user 610. The output informationprovided by CARE can include, but is not limited to, text, audio, video,images and vibration. Accordingly, user 610 can perform the actionsprovided as recommendations. For example, the recommendations can be totake a reading from an electrocardiograph or to call a physician.Subsequently, the CARE automatically sends instructions based onanalysis of the input data to one or more of, but not limited to, acomputing device 612, a new department of users, and an on-lineprivate/public human/social network of users and an on-lineprivate/public forum of users. For example, the CARE may instruct thecomputing device 612 to request an X-ray procedure for a patient.

The CARE may recommend the user 610 to perform certain actions relatedto patient-care in a stepwise manner based on a standard treatmentclinical protocol, wherein user 610 can provide an input regardingstatus of each step. User 610 utilizes one or more buttons displayed onUI of computing device 612 to indicate if the recommended action iscompleted or rejected. For example, the first step of recommendation canbe to take a reading from an automatic blood pressure measuring device.Once the reading is taken, a nurse provides input to computing device612 as the first step is performed which in turn displays that thesystolic pressure is above 120, so alert/call a physician. In accordancewith the example, the computing device 612 recommends the attendedphysician to perform necessary patient-care actions to treat thepatient. Thereafter, the physician performs the recommended actions andprovides input to the computing device 612 as a confirmation of actionperformed.

For example, in an advanced cardiac support situation, the computingdevice 612 may recommend that the doctor perform one or more treatmentsteps based on a standard of care clinical protocol in a particularamount of time by displaying instructions on the display screen, byvoice instructions, or other visual or audio cue (such as voiceinstructions, tones, diagrams, lights. etc.). Additionally, a countdowntime may also be provided while the recommendations are being provided.Further, additional alarms, tones, lights, and other additional cues maybe provided during the countdown to encourage the doctor to perform therecommend treatment step or steps within the required time. Based on aninput received from the doctor the computing device 612 may determine ifthe standard of care clinical protocol has been adhered to or has beendeviated from. Based on this determination, the computing device 612 mayinclude a recommendation engine to provide additional recommendationsbased on predetermined algorithms. For example, if the computing device612 determines that the clinical protocol has been followed and thetreatment steps have been performed as required, the next step in theclinical protocol may be recommended. However, if the computing device612 determines that the clinical protocol has not been followed;different treatment steps may be recommended to drive the treatment backto the clinical protocol.

Consider another example, where the computing device 612 may alert apharmacist keeping track of availability of specific medicines, whichmay be scarce or difficult to procure. The computing device 612 afteranalyzing one or more medical conditions of a patient may determine thatthe patient may require a specific medicine in the near future.Accordingly, the computing device 612 may alert a pharmacist to maintaina stock of, or to commence procurement of, the specific medicine.Depending on the stock availability or procurement status, an input maybe provided by the pharmacist to the computing device 612 via network614 confirming the availability of the specific medicine or sending anupdate regarding non-availability of the specific medicine.

The CARE can also be used to facilitate training of the user 610 toadhere to one or more care clinical protocols associated with one ormore medical conditions. For example, the CARE can be configured toenable a simulation of a real-time event, such as, but not limited to, amedical emergency.

The CARE also may record inputs and actions performed by user 610 whilefacilitating patient-care. The CARE accordingly may enable the user 610to view the recorded inputs and actions to be used for auditing andcompliance purposes. For example, the recorded information can be usedto check if a nurse performed actions as per a standard of care clinicalprotocol in response to a medical condition. Taking another example, thedata of a healthcare department or multiple healthcare departments canbe audited to check for compliance. Similarly, the data corresponding toan entire hospital can be reviewed for audit and compliance purposes.

Computing device 612 can also be integrated with one or more systemssuch as, but not limited to, patient monitoring units 630, hospitalinformation systems (HIS) 632 and third party systems 634. Patientmonitoring units 630 may include, but are not limited to, anintra-aortic balloon pump (IABP), an arterial blood gas (ABG), aventilator and a bed-side monitor. The HIS 632 disclosed herein caninclude one or more systems such as, but not limited to, an Epic®system, a Cerner® system and a Hinai® system. Third party systems 634may include, but are not limited to, system owned or controlled bypayors, hospitals, clinics, primary care centers, diagnosticlaboratories, pharmacies, nursing homes, physicians, nurses and otherhealthcare service delivery points. Optionally, clinical applicationstore 602 can be integrated with the one or more systems including, butnot limited to, patient monitoring units 630, HIS 632 and third partysystems 634. Accordingly, computing device 612 can access one or more ofpatient monitoring units 630, HIS 632 and third party systems 634 viathe clinical application store 602.

The integration between the one or more systems, one or more computingdevices 612 and the clinical application store 602 can be performed toenable a plurality of applications. For instance, the integration can beperformed to enable exchange of information between the computing device612 and the patient monitoring units 630. For example, a blood pressuremonitor can be integrated with the computing device 612 to feed bloodpressure data to the computing device 612. In accordance with thisexample, computing device 612 may also trigger a blood pressure reading.Similarly, clinical application store 602 can be integrated with HIS 632to enable access to data stored in the HIS 632. Likewise, third partysystems 634 can be integrated to enable access to information related totreatment clinical protocols.

The system 600 need not be limited to one computing device such as 612and one user such as user 610 as illustrated in FIG. 6. Multiple devicesand users may simultaneously utilize the system 600. Further, system 600can include additional components and/or integrations with externalsystems or between components than the ones mentioned above. Further,each component can have other functions than the ones listed above. Suchvariations would be readily apparent to those ordinarily skilled in theart.

System 600 can be used for multiple applications. For example, system600 can be used for ensuring compliance with standard of care clinicalprotocols, accessing/developing patient-care applications, datagathering and analysis, viewing trends and so forth.

In one exemplary application, system 600 is configured to enable one ormore application developers to develop patient-care applications usingthe clinical application store 602. In addition, system 600 may beconfigured to enable the one or more application developers to uploadthe plurality of patient-care applications to the clinical applicationstore 602 for the one or more healthcare providers. Additionally, system600 may be configured to enable the one or more application developersto access one or more of the HIS 632 and the third party systems 634 viaclinical application store 602. The one or more application developerscan use the HIS 632 and/or third party systems 634 to improve the designof the plurality of patient-care applications. Further, system 600 isconfigured to provide the application developers with softwaredevelopment toolkits (SDKs), User Interface (UI) template/patterns,style/coding guidelines, application programming interfaces (APIs),clinical experts, social network, community forums, source-codetemplates, release notes and access to clinical tests and clinicalverification sites for developing the plurality of patient-careapplications. The application developers may create a new clinicalapplication faster and with ease using such information. System 600 isalso configured to enable the one or more application developers toupdate the patient-care applications if there is a need to improvepatient-care systems of the one or more healthcare providers.

In another exemplary application, system 600 is configured to enable oneor more payors to access one or more of the plurality of patient-careapplications in clinical application store 602 to determine the amountto be paid to one or more healthcare providers. The one or more payorscan be one or more of, but not limited to, a patient, an insurancecompany, a health maintenance organization, a healthcare servicecontractor, a legal entity which is self-insured and provides benefitsfor healthcare services to employees, a legal entity responsible forhandling claims for healthcare services under a medical assistanceprogram, a local government which pays for healthcare services, aninsurer authorized to transact workers' compensation or casualtyinsurance, and an employer authorized to self-insure workers'compensation risk. Accordingly, payors may access the computing device612 to determine the amount to be paid to the one or more healthcareproviders.

In yet another exemplary application, the CARE may be used to providetraining to user 610 for facilitating patient-care. The CARE may also beconfigured on a plurality of computing devices for training a group ofusers for handling one or more medical conditions in accordance withstandard of care clinical protocols or for creating a simulatedenvironment of one or more of a healthcare department, a group ofhealthcare departments and a hospital. For example, a group of nursescan be trained to provide patient-care according to standard of careclinical protocols for a medical condition by using the multiplebed-side devices to simulate a real-time situation corresponding to themedical condition. Likewise, different nurses can be trained fordifferent medical conditions by simulating real-time situations for thecorresponding medical conditions and nurses. Similarly, users ofdifferent departments of the hospital can be trained by simulatingreal-time situations using the CARE configured on client devices ofcorresponding departments.

System 600 can be accessed in multiple ways for facilitatingpatient-care with adherence to standard of care clinical protocols asdiscussed in the various examples and example implementations describedabove, or as may be apparent to a person of ordinary skill in the art.

FIG. 9 illustrates a flowchart of a method for facilitating patient-carewith adherence to standard of care clinical protocols in accordance withan example implementation of the present application.

At step 902, a computing device such as computing device 612 receivesrole information of a user such as user 610. The role information can bereceived automatically when user 610 logs on to computing device 612.For example, the login details of user 610 can be used to retrieve therole information of user 610 from a database. Alternately, user 610 canprovide the role information by entering details such as, but notlimited to, personal identity number, department number, field ofexpertise, specialization information into the computing device 612. Therole information can include one or more, but not limited to, jobinformation, and department information. The job information may providedetails regarding user 610's position within a healthcare organization.In some example implementations, the job information may identify a user610's position as one or more of, but not limited to, a doctor, a nurse,a technician, an administrator, a patient and a payor. The departmentinformation may provide details regarding a department associated withuser 610 within a healthcare organization. In one implementation, thedepartment information may identify the department associated with user610 as one or more of, but not limited to, Cardiology, InternalMedicine, OB/GYN, Oncology, Radiology, Surgery, and Pediatrics.

At step 904, a plurality of patient-care applications targeted to user610 may be identified based on the received role information. In oneimplementation, computing device 612 identifies the plurality ofpatient-care applications based on the received role information.

The plurality of patient-care applications can be mobile applicationsidentified from clinical application store 602. Further, the pluralityof patient-care applications can include one or more of, but not limitedto, condition related applications 620, support applications 622,training applications 624, image viewer applications 626 and laboratoryapplications 628. For example, if the user 610 is identified as a nurse,then a plurality of nursing related applications may be identified.Similarly, if the user 610 is identified as a cardiologist, then aplurality of cardiology related applications may be identified.

In some example implementations, if the received role informationidentifies user 610 as a patient, then, optionally at step 906,computing device 612 may accesses the HIS 632 to retrieve one or more ofdiagnosis information and treatment information associated with user610. Thereafter, computing device 612 may utilize the retrievedinformation, in addition to the received role information to identify aplurality of patient-care applications. Optionally, computing device 612may provide the HIS 632 with information about the identifiedpatient-care applications.

At step 908, summary information for identified patient-careapplications is provided to user 610 by computing device 612. Thesummary information may include a list of the identified patient-careapplications. In addition, a brief description of each patient-careapplication may be provided. Further, the summary information may enableuser 610 to select one or more of the identified plurality ofpatient-care applications. Thereafter, user 610 may be allowed to selectone or more of, the patient-care applications listed in the summaryinformation.

At step 910, user 610 may select one or more of the patient-careapplications. For example, user 610 can select a plurality of conditionbased applications listed in the summary information. Selection of theplurality of condition based applications can include selection of, butnot limited to, one or more cardiac applications, one or more nephrologyapplications, one or more respiratory applications, one or more diabetesapplications, one or more arthritis applications, one or more asthmaapplications or any other applications that may be apparent to a personof ordinary skill in the art.

At step 912, the selected patient-care applications may be accessed vianetwork 614 e.g., installed on computing device 612 in order to grantaccess to the selected applications. User 610 may access thepatient-care applications for one or more of, but not limited to,providing input regarding patient medical conditions, receiving output,and receive patient-care instructions and recommendations.

FIG. 10 illustrates a flowchart of a method for facilitatingpatient-care with adherence to standard of care clinical protocols inaccordance with another example implementation of the presentapplication.

At step 1002, computing device 612 provides a request to user 610 forproviding patient condition information as an input. Computing device612 provides the request for patient condition information based on oneor more of a treatment clinical protocol and the received roleinformation. For example, a request for entering blood pressureinformation of a patient may be provided to a nurse. Alternately, arequest for uploading an x-ray image of a patient may be provided to aradiologist. The request for patient condition information is given touser 610 in one or more ways. For example, the request may be providedon a UI of computing device 612 for entering information. Alternately oradditionally, an audio and/or visual alert may be provided indicatingthat patient condition information is required to be input. Moreover, anemail or telephonic message may be sent for requesting the patientcondition information.

The instructions may be provided according to the type/configuration ofcomputing device 612. For instance, when computing device 612 is atouch-enabled device such as, but not limited to, a smartphone, awearable device (such as a smart watch), a tablet, and a notebook, theinstructions may be provided such that a touch-screen display ofcomputing device 612 may be used for viewing and completing theinstructions. Taking another instance, where computing device 612includes separate display and input interfaces such as in desktops, theinstructions may be rendered via the display of computing device 612while enabling the corresponding user input from the input interfacessuch as, but not limited to, a keypad, a keyboard and a mouse. Takingyet another instance, where computing device 612 is configured tocollect input from patient monitors such as, but not limited to, bloodpressure sensors and glucose monitors, the configuration can be suchthat computing device 612 manages the patient monitors for collectingthe desired patient data. For example, a wearable device withincorporated sensors may monitor patient vitals or movements using thesensors. It will be apparent that the manner in which instructions areprovided and in which user input may be collected need not be limited tothe examples provided above and numerous variations would be apparent tothose ordinarily skilled in the art.

Providing the request for patient condition information can includetransmitting a timing condition to a countdown timer for display. Thedisplayed timing condition as shown in FIG. 11 can specify a length oftime within which user 610 needs to provide the requested information.Accordingly, the countdown timer can display the amount of time user 610has for providing the requested information. For example, the user 610may be instructed to provide 10 respiratory volume measurements within a2 minute time frame and a timer could begin counting down. As the end ofthe countdown approaches additional audio or visual cues may be providedsuch as alarms, tones, voice instructions, flashing lights, etc. may beprovided.

Optionally, the request for providing the patient condition informationmay include instructing user 610 to attach one or more of patientmonitoring units 630 to the patient.

At step 1004, computing device 612, receives the patient conditioninformation as an input. For example, computing device 612 may receiveinput directly from user 610 via an interface rendered on computingdevice 612. Taking another example, computing device 612 may receiveinput from the one or more patient monitoring units. Taking yet anotherexample, computing device 612 may receive input from both user 610 andthe one or more patient monitoring units. Optionally, computing device612 may connect to HIS 632 to update a patient record with the receivedpatient condition information from user 610. Thereafter, at step 1006,computing device 612, analyzes received patient condition information.The analyses may include applying one or more analytical techniques onthe received input to identify patient-care instructions. For example,if the input is a text input, natural language processing may be used toanalyze the input and identify the patient-care instruction. Similarly,if the input is received from a patient monitoring unit, a signalanalysis technique may be utilized to determine the patient conditionfor identifying the patient-care instructions.

Additionally, an input may also include a confirmation that therecommended steps of treatment were not performed. For example, a usermay indicate that a requested number of measurements were not taken, orthe recommended procedures were not performed.

Based on the input received, the computing device 612 determines, usingalgorithms developed based on the standard of care clinical protocol asdiscussed above, whether the standard of care clinical protocol has beenadhered to, whether patient-condition information is within expectedvalues associated with the standard of care clinical protocol, andidentifies what additional treatment steps should be performed. Forexample, in one implementation, a standard of care clinical protocol mayrequire that the patient perform a respiratory volume flow measurement10 times per hour every hour and that the volume flow meet or exceed aspecific volume. If the input indicates that the required measurementsare being taken as scheduled and are within the ranges specified by theclinical protocol, the application may recommend continuing themeasurements for 7 days without needing to see a doctor. Conversely, ifthe input indicates that the measurements are only being taken twice perhour and the respiratory volume flow measurements are repeatedly belowthe required volumes, the application may recommend that patientimmediately seek out a respiratory specialist for additional treatment.

At step 1008, computing device 612, provides patient-care instruction touser 610 based on the treatment clinical protocol. Providing patientcare instructions may include transmitting instructions such as, but notlimited to, take one or more measurements of patient vital signs, obtainone or more patient specimens and perform one or more diagnostic tests(e.g., laboratory tests, imaging tests, etc.) on the one or more patientspecimen, perform one or more radiological imaging tests, perform one ormore physiological tests and perform one or more medical procedure.Further, providing the patient-care instructions may include providing atiming condition specifying a time period within which the instructionsare to be performed by user 610. For example, a count-down timer may beprovided counting down the time remaining to perform the specifiedactions. Further, as the end of the countdown approaches additionalaudio or visual cues may be provided such as alarms, tones, voiceinstructions, flashing lights, etc. may be provided. The timingcondition as displayed in FIG. 13 can be provided to a count-down timerfor displaying the amount of time user 610 has for completing theinstruction.

Optionally, computing device 612 may connect with HIS 632 for accessingand correlating additional patient-care information with receivedpatient-care information based on the treatment clinical protocol.Subsequently, the computing device 612 may provide additionalpatient-care instructions such as, but not limited to, a combination ofretrieved additional patient-care information and received patient careinformation annotated with diagnostic information based on the treatmentclinical protocol.

At step 1010, user 610 performs the patient-care instructions providedby computing device 612. User 610 can perform patient-care instructionsand recommendations given by computing device 612 in a step-by-stepmanner as displayed on computing device 612.

User 610 may perform the patient-care instructions in accordance with atiming condition specified by the patient-care instructions. Forexample, as shown in FIG. 13, a user 610 may provide Advanced CardiacLife Support (ACLS) within 2 minutes. Alternately, the user 610 may calla cardiac specialist within 2 minutes.

Subsequently, at step 1012, user 610 may provide a confirmation tocomputing device 610 after performing the patient care-instructions.User 610 provides the confirmation to the computing device 612 byselecting a display button on a UI provided on the computing device 612.

Computing device 612 may also update HIS 632 about patient-careinstructions that were transmitted and performed by the user 610 on thepatient.

By providing instructions or recommendations of treatment steps to beperformed and obtaining feedback input from the user, the computingdevice 612 can determine if the standard of care clinical protocols arebeing adhered to in real time and use a recommendation engine to providerecommendations to drive the treatment back to the standard of careclinical protocol if the clinical protocol has been deviated from. Thus,the standard of care clinical protocols can be uniformly appliedindependent from the role of the user, and independent from thedepartment or location of the user or the patient.

FIGS. 11, 12, and 13 illustrate an example user interfaces used byexemplary applications the method and systems disclosed herein. Inaccordance with the scenario, assume that a patient with a medicalcondition of cardiac arrest enters a hospital. A user 610 such ascardiac specialist within healthcare organization may access clinicalapplication store 602 via computing device 612, by providing roleinformation of user 610. Thereafter, one or more appropriatepatient-care applications are identified based on the provided roleinformation. Subsequently, the selected patient-care applications aredownloaded and installed in computing device 612.

In accordance with the scenario, user 610 can select one of the listedcardiac arrest applications. Accordingly, a selected cardiac arrestapplication that is installed in computing device 612 provides thesimplified user interface (UI) 1100, as illustrated in FIG. 11 forprompting user 610 to input details of a medical condition of thepatient. One or more details of medical condition of the patient such asfor example, tachycardia, in this scenario, to be entered into an inputblock 1102 is displayed on UI 1100 of the computing device 612.Accordingly, user 610 provides one or more inputs such as, for example,mental status of the patient, oxygen saturation of the patient, andpalpable pulse of the patient into input block 1102.

FIG. 12 illustrates an alternative UI 1200 providing a checklist ofactions 1205 to be performed, a countdown timer 1210, links 1215 toprotocols applicable to the patient, and other various informationapplicant to the treatment of the patient.

The simplified UI 1100 of FIG. 11 may be used in situations where theuser has a role requiring a minimum amount of information (such as anurse, intern, etc.), and the complex UI 1200 of FIG. 12 may be usedwhere the user has a role requiring more detailed information (such asintensivist, surgeon, etc.). Alternatively, the simplified UI 1100 ofFIG. 11 may be used in situations where there is history of the user notadhering to the protocol to encourage the user to adhere to theprotocol. Further, the complex UI 1200 of FIG. 12 may be used insituations where there is history of the user adhering to the protocol.The different UIs may also be used in a variety of other differentsituations as may be apparent to a person of ordinary skill in the art.

Simultaneously, computing device 612 may also receive informationregarding a medical condition of the patient from patient monitoringunits 630 that are attached to the patient. The received information isanalyzed and an alarm is triggered if a condition trigger specified by atrigger element is met.

Computing device 612 analyzes the details of medical conditions receivedfrom user 610 and/or patient monitoring units 630 and displays possiblediagnosis information such as, but not limited to, Bradycardia,Arrhythmia, Tamponade, Pneumothorax, Hemorrhage, Myocardial Infraction,Pulmonary Embolism, Sepsis, and Medication Effects. Thereafter dependingon one or more diagnosed conditions of the patient and the standard ofcare clinical protocols for cardiac arrest, the cardiac arrestapplication displays certain actions, recommendations, instructions andtasks in recommended tasks block 1302 shown in FIG. 13.

Accordingly, user 610 can perform actions as instructed and acknowledgethe action using computing device 612. Thereafter, user 610 may beprovided with next recommended steps of instructions that are to beperformed such as, for example Advanced Cardiac Life Support (ACLS)1304. It may be apparent that all instructions and recommendationsmentioned to user 610 are performed on the patient in accordance withstandard of care clinical protocols based on medical conditions.

FIG. 14 illustrates a dashboard UI 1400 that can be used to display acomplete overview of a patient's treatment. The dashboard UI 1400 caninclude a summary of patient information (name, age, diagnosis,treatment, etc.) 1405, patient vitals (HR, BP, SPO2, CVP, etc.) 1410,fluid input/output 1415, prescribed medicine 1420, assigned equipment1425, and investigations 1430. Further, the Dashboard UI 1400 may alsoinclude a summary of adherence to protocols 1435, outstandingorders/follow-up 1440. The Dashboard UI 1400 may also provide links oricons representative of active protocols 1445, and critical warnings1450.

In some implementations the UIs of FIGS. 11-13 may be controlled andincorporated into a recommendation engine and the UI 1400 of FIG. 14 maybe controlled and incorporated into a monitoring engine.

The method and system disclosed herein may facilitate in providingpatient-care with adherence to standard of care clinical protocols,which can help to reduce chances of errors in a healthcare environmentand improve patient safety. The disclosed method and system may help toenable faster response time to medical conditions of a patient and makedecisions for patient-care. As the disclosed method and system may bespecific to facilitating patient-care with adherence to standard of careclinical protocols associated with medical conditions, the method andsystem may assist in improving the quality and consistency of patientcare. Thus, favorable outcomes may be a result of utilizing thedisclosed method and system. The processes of patient-care may bestandardized for handling an event and first line of responses for eachmedical condition. The disclosed method and system may be user-friendlyand may enable healthcare professionals and patients to easily adopt forproviding patient-care. The learning curve of a user for patient-careknowledge may also be shortened as the user can be trained on-the-job.

The disclosed system and method may be utilized for providingpatient-care to a patient until the patient is clinically fine, as wellas after the completion of the clinical care has been completed, toprevent a future recurrence of the clinical condition, or other clinicalconditions. The patient-care applications of clinical application store602 can also be used when the patient is travelling to a healthcareprovider, during admission, in the premises of the healthcare provider,or after discharge and at home under observation. Due to easyaccessibility to various patient-care applications using clinicalapplication store 602, mortality and morbidity rates may be reduced.Since the patient-care applications are designed using the standard ofcare clinical protocols specific to a medical condition, the healthcareproviders can adhere to the standard of care clinical protocols. Thedisclosed method and system may also provide a single source for variouspatient-care actions such as, but not limited to, generalinvestigations, audit, compliance, malpractice investigations,evaluations and quality assurance.

In the foregoing specification, specific example implementations of thepresent application have been described. However, one of ordinary skillin the art appreciates that various modifications and changes can bemade without departing from the scope of the present application as setforth in the claims below. Accordingly, the specification and figuresare to be regarded in an illustrative rather than a restrictive sense,and all such modifications are intended to be included within the scopeof the present application. The benefits, advantages, solutions toproblems, and any element(s) that may cause any benefit, advantage, orsolution to occur or become more pronounced are not to be construed ascritical, required, or essential features, of the present application.

What is claimed is:
 1. A computer-implemented method for facilitatingdelivery of patient-care, the method comprising: monitoring, by acomputing device, patient information indicative of a clinicalcondition, based on a clinical protocol that comprises patient-careinstructions that must be completed within a time period; providing, bythe computing device, the patient-care instructions to a user based on aresult of the monitoring; determining, by the computing device,adherence to the clinical protocol based on a result of at least one ofthe providing patient care instructions and the patient information; andfor a determination that the clinical protocol has not been adhered to,providing a recommended action request that calibrates the patient careinstructions in compliance with the clinical protocol.
 2. Thecomputer-implemented method of claim 1, wherein the monitoring patientinformation comprises specifying that at least one of the patientinformation be provided and the patient-care instructions be performedwithin the time period.
 3. The computer-implemented method of claim 1,further comprising displaying to the user a count-down timer that isindicative of the time period.
 4. The computer-implemented method ofclaim 1, wherein the providing patient-care instructions comprises atleast one of: taking one or more measurements of patient vital signs;obtaining one or more patient specimens and performing one or morelaboratory tests on the one or more patient specimens; performing one ormore radiological imaging tests on a patient or the one or more patientspecimens; performing one or more physical diagnostic tests on thepatient; and performing one or more medical procedures on the patient.5. The computer-implemented method of claim 1, further comprising:accessing, by the computing device, a hospital information system toretrieve additional patient information; correlating, by the computingdevice, the retrieved additional patient information with the monitoredpatient information based on the clinical protocol; and wherein theproviding the patient-care instructions comprises displaying acombination of the retrieved additional patient information, themonitored patient information, and diagnostic information based on theclinical protocol.
 6. The computer-implemented method of claim 1,further comprising receiving role information of the user; wherein themonitoring patient information comprises requesting patient informationbased on the received role information of the user; and wherein thepatient-care instructions are provided based on the received roleinformation of the user.
 7. The computer implemented method of claim 1,wherein the patient-care instructions are provided based on adetermination of compliance with the standard of care protocol.
 8. Anon-transitory computer readable medium having stored therein computerexecutable instructions for causing a computing device to perform themethod comprising: monitoring, by a computing device, patientinformation indicative of a clinical condition, based on a clinicalprotocol that comprises patient-care instructions that must be completedwithin a time period; providing, by the computing device, thepatient-care instructions to a user based on a result of the monitoring;determining, by the computing device, adherence to the clinical protocolbased on a result of at least one of the providing patient careinstructions and the patient information; and for a determination thatthe clinical protocol has not been adhered to, providing a recommendedaction request that calibrates the patient care instructions incompliance with the clinical protocol.
 9. The non-transitory computerreadable medium of claim 8, wherein the monitoring patient informationcomprises specifying that at least one of the patient information beprovided and the patient-care instructions be performed within the timeperiod.
 10. The non-transitory computer readable medium of claim 8,further comprising displaying to the user a count-down timer that isindicative of the time period.
 11. The non-transitory computer readablemedium of claim 8, wherein the providing patient-care instructionscomprises at least one of: taking one or more measurements of patientvital signs; obtaining one or more patient specimens and performing oneor more laboratory tests on the one or more patient specimens;performing one or more radiological imaging tests on a patient or theone or more patient specimens; performing one or more physicaldiagnostic tests on the patient; and performing one or more medicalprocedures on the patient.
 12. The non-transitory computer readablemedium of claim 8, further comprising: accessing, by the computingdevice, a hospital information system to retrieve additional patientinformation; correlating, by the computing device, the retrievedadditional patient information with the monitored patient informationbased on the clinical protocol; and wherein the providing thepatient-care instructions comprises displaying a combination of theretrieved additional patient information, the monitored patientinformation, and diagnostic information based on the clinical protocol.13. The non-transitory computer readable medium of claim 8, furthercomprising receiving role information of the user; wherein themonitoring patient information comprises requesting patient informationbased on the received role information of the user; and wherein thepatient-care instructions are provided based on the received roleinformation of the user.
 14. The non-transitory computer readable mediumof claim 8, wherein the patient-care instructions are provided based ona determination of compliance with the standard of care protocol.
 15. Acomputer-implemented method for distributing patient-care mobileapplications to a user, comprising: receiving, by a computing device,role information about the user; identifying a plurality of patient-caremobile applications targeted to the user based on the received roleinformation; providing, by the computing device, summary information forthe identified plurality of patient-care mobile applications to theuser; receiving, by the computing device, selection information from theuser identifying one of the plurality of patient-care mobileapplications; and granting access to the identified one of the pluralityof patient-care mobile applications.
 16. The computer implemented methodof claim 15, wherein the role information comprises job information ofthe user within a healthcare organization; and wherein one or more ofthe patient-care mobile applications are identified based on the jobinformation.
 17. The computer implemented method of claim 16, whereinthe job information comprises information indicative of the user'sposition as at least one of doctor, nurse, technician, administrator,patient, and payor.
 18. The computer implemented method of claim 15,wherein the role information comprises department informationidentifying a department associated with the user within a healthcareorganization; and wherein one or more of the patient-care mobileapplications is identified based on the department information.
 19. Thecomputer implemented method of claim 18, wherein the departmentinformation comprises information indicative of the departmentassociated with the user as at least one of: Cardiology, InternalMedicine, Obstetrics/Gynecology, Oncology, Radiology, Surgery,Pediatrics, Neonatology, Emergency Medicine, Nephrology, andDermatology.
 20. The computer implemented method of claim 15, furthercomprising: accessing, by the computing device, a hospital informationsystem to determine diagnosis information associated with the user whenthe role information identifies the user as a patient, wherein theidentifying the plurality of patient-care mobile applications based onthe received role information comprises identifying the plurality ofpatient-care mobile applications based on the determined diagnosisinformation.
 21. A system for facilitating delivery of patient-care, thesystem comprising: a first computing device comprising a first storageand a first processor configured to perform: monitoring patientinformation indicative of a clinical condition, based on a clinicalprotocol that comprises first patient-care instructions and secondpatient-care instructions that each must be completed within a timeperiod; providing the first patient-care instructions to a first userbased on a result of the monitoring; determining adherence to theclinical protocol based on a result of at least one of the providing thefirst patient care instructions and the patient information; and for adetermination that the clinical protocol has not been adhered to by thefirst user, providing a first recommended action request that calibratesthe first patient care instructions in compliance with the clinicalprotocol; and a second computing device comprising a second storage anda second processor configured to perform: monitoring patient informationindicative of the clinical condition, based on the clinical protocolthat comprises the first patient-care instructions and the secondpatient-care instructions that must be completed within the time period;providing the second patient-care instructions to a second user based ona result of the monitoring; determining adherence to the clinicalprotocol based on a result of at least one of the providing the secondpatient care instructions and the patient information; and for adetermination that the clinical protocol has not been adhered to by thesecond user, providing a second recommended action request thatcalibrates the second patient care instructions in compliance with theclinical protocol; wherein the first computing device and the secondcomputing device are each configured to provide an indication ofadherence to the clinical protocol of the first user and the seconduser, respectively in a substantially common presentation format.